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Relactation during pregnancy

Hi, a little background. I am nursing a 14 month old. She was a donor egg baby and breastfeeding has been a wonderful experience that I didn't expect, despite struggling with low supply. I think I was just so determined, especially after the struggle to become pregnant. I don't feel that either of us is ready to wean, but I am 44 and desire another pregnancy. I am going for the initial visit this week with an eye to an embryo transfer from leftover frozen embryos in March. I was told that once I start on estrogen and progesterone I must wean so my baby is not exposed. I have to take hormones the whole first trimester. I am very sad about weaning. My question is twofold. I don't want to lose any of this precious time by starting to wean early, yet how can I make this less stressful for us? We co-sleep. She is very insistent at night and early am. I work 3 days a week and still pump at work. Secondly, what about offering her the breast again after my first trimester and tandem nursing if she wishes? Maybe I won't have to struggle so much with supply the second go round? I took domperidone this time and still had to supplement. Thank you

Re: Relactation during pregnancy

:/ Hmm, the reason you were given for weaning seems odd. Women routinely nurse through pregnancy, producing high levels of endogenous estrogen and progesterone, and no-one says that they need to wean in order to protect their babies from those home-brewed hormones. Why would estrogen/progesterone that comes via pill or syringe be so different? Unless the levels that they intend to use are extremely high. I would ask your care providers for some clarification on what levels of hormones you'll be dealing with- are they really going to be crazy high? Or are they shooting for something close to the norm for a pregnant woman?

Now, if there's some reason that breastfeeding would be a risk for the pregnancy, I can see the point in weaning. High prolactin can result in lower estrogen, and maybe that would present some sort of risk. Again, this seems like a question to ask your caregivers, as does your question about unweaning in the second trimester. If nursing presents a risk in the first trimester, what makes the second different?

If you decide to wean, I would start by dropping the workday pumping sessions. Most moms pump wean at around 12 months. A decrease in milk supply might de-incentivize nursing for your toddler, encouraging her to seek other forms of nutrition and comfort. Some more things that may help:
- Enlist alternate caregivers, especially for those times of day when your child is most eager to nurse.
- Wear restrictive clothing, including pajamas- if your baby can't easily get her hands on your goodies, she may be less inclined to want to nurse
- Offer lots of snacks and sippy cups throughout the day- the less hungry/thirsty she is, the less likely she is to want to nurse
- Keep a sippy or bottle of water available at night- night-waking toddlers may be genuinely thirsty
- Abandon co-sleeping (temporarily)- have someone else share sleep with your daughter and deal with nighttime wake-ups
- Set limits on nursing- e.g. nurse only for a 10-count, or nurse only in the house, or nurse only until you finish singing a song
- Communicate- explain that you're not going to nurse overnight, or not right now. Even preverbal kids can often grasp the essentials.
- Avoid your customary nursing locations. Babies are often cued to nurse by seeing you in your favorite nursing spot.
- Be consistent. If you decide to wean, just power through any drama. It will go faster than if you vacillate.

Regardless of what you choose WRT weaning now, there's good reason to think that you'll have better supply when your new baby arrives. A second pregnancy means your breasts get a second round of pregnancy hormones preparing them to lactate. Many moms notice increased supply with their second, third, fourth, etc., babies.

Re: Relactation during pregnancy

Thanks Mommal. I definitely planned to ask again about the hormones. Sometimes the answer you get through the nurse is different than. Directly from the doctor. The answer I got was that it was a risk to the nursing. It sounds like you recommend starting before I have to quit. That is what I'm dreading. I don't want to miss a moment. Itis particularly sad as I will likely know when the last session will be, unlike most Mamas, making the last particularly sad.

Re: Relactation during pregnancy

I think it helps to think of weaning as a process, rather than as something with well-defined start and end dates. We begin the weaning process the moment we offer our babies their first tastes of solid food. So you're already on your weaning journey.

If the answer is that you really should wean- and I would seek several opinions on this, including from some midwives, who tend to be more breastfeeding-friendly than OBs- I wonder if you could keep just 1-2 nursing sessions per day. That might allow you the long goodbye you're looking to have.

Re: Relactation during pregnancy

Hmmmm, maybe check exactly what you'll be taking and call infant risk? They can help you decide what, if any, risks you'll be taking if you continue to nurse. Ditto asking multiple health care providers. Too many docs just don't have any clue about breastfeeding.
Adventures in Tandem Nursing by Hillary Flower is the book I always recommend to pregnant nursing moms but I've got a sleeping toddler on me and can't get up to check if it says anything about in vitro. Whether you 'll be able to continue later in the pregnancy is very individual. Most mothers lose their milk supply in the second trimester until colostrum comes back in during the second/third trimester. Some kids nurse through that fine, Some choose to wean. Some kids also choose to wean themselves due to taste changes later in pregnancy. Some kids wean and come back to nursing when baby arrives with fresh milk. Personally, I'm 28 weeks with a nursing 2.5 yo. I did have zero milk for a month and he's commented on the taste but nothing stops this kid from nursing :l
Abrupt weaning is not recommended. It puts you at risk for plugged ducts and mastitis while being traumatic for the baby. So you'll want to drop a session at a time, giving your body several days or weeks to adjust to the lower demand. So I think that's why mommal suggested starting now. If weaning is necessary, you'll likely need the two months that you have to do so properly. I'm terribly sorry mama. This is a heart wrenching thing to decide.

Re: Relactation during pregnancy

I have a mobile app version of Medications and Mother's Milk--estrogen and progesterone are both considered category L3 for lactation (i.e., "probably safe"). There is some risk, of course, that these drugs will decrease your milk supply, but no indication that they make nursing unsafe.

If it is just one nurse telling you that these drugs are incompatible with nursing, I would suggest that this particular nurse is most likely misinformed. Unfortunately, many, many, many health care professionals do not know the correct answer about whether or not a medication is safe or not while a mom is nursing, and tend to knee jerk recommend that mom wean whenever they are faced with a question! I would agree with the PP's recommendation to find out from an informed source whether or not nursing is a risk to a potential pregnancy in your particular case; but if the concern is just that of the medication in your milk, I do not think you have to wean. Can you call and discuss this with Dr. Hale's InfantRisk team? They are the true experts on this front!

Apologies for the short responses! I'm usually responding one-handed on my smartphone!

Re: Relactation during pregnancy

So I had my appointment, and the RE said nursing is not a danger to the nursing toddler, but makes a new pregnancy less likely to "take." So, for now I have quit pumping but feel less pressure to stop co sleeping. My toddler nurses 3-4 times a day and I intend to " play it by ear". Not offering but not refusing. If the first embryo transfer fails, we have 3 more and I might decide to wean if it fails, to remove that possibility of am effect.